A Brief Discussion of Pain

Of all the sensations the human body experiences pain is by far the most debilitating. As a perceptual phenomenon pain is difficult, if not impossible, to measure. What is severe pain to one person may be mild to another. The intensity of the pain depends in large part on the individual’s tolerance for pain. The International Association for the Study of Pain (IASP) employs a classification system that categorizes pain according to (1) cause, (2) duration and severity, (3) anatomical location, (4) body system involved (musculoskeletal, nervous, etc.), and (5) temporal characteristics (intermittent, constant, etc.).

Confounding the pain issue is the fact that it can be difficult to determine exactly what is causing the pain. In instances where the organic cause of the pain cannot be identified it is termed psychogenic pain (i.e., “in the person’s head”) and not an actual system dysfunction. The fact that psychogenic pain can not be diagnosed does not mean that it can not be treated. Treatment alternatives can include psychotherapy, non-narcotic painkillers, or antidepressants used singly or in combination.

Pain occurs in one of two modalities or types – transitory or acute pain and constant or chronic pain. Mild to severe acute pain occurs suddenly. If the pain is mild it is usually of limited duration lasting from days to weeks and sometimes months until the cause of the pain has been identified and treated (broken bone, muscle strain, toothache, etc.). Failure to treat acute pain promptly and properly may result in chronic pain.

Chronic pain is usually difficult to manage or control. Chronic pain remains active in the nervous system for protracted periods of time. It is often accompanied by emotional reactions such as anxiety, depression, anger, etc. and can have serious psychosocial ramifications. This is particularly true in intimate interpersonal relationships such as marriage. The etiology of chronic pain includes damage to nerves (neurogenic pain), arthritis pain, psychogenic pain, headache pain, etc.

Acute and chronic pain can be treated using multiple modalities: drugs (pharmacotherapy), minimally-invasive and open surgery, physical therapy, psychological counseling/behavior modification, electrical stimulation, massage, relaxation and biofeedback therapy.